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Tytuł pozycji:

High rates of pulmonary artery occlusions in COVID-19. A meta-analysis.

Tytuł:
High rates of pulmonary artery occlusions in COVID-19. A meta-analysis.
Autorzy:
Birocchi S; Unità di Medicina II, ASST Santi Paolo e Carlo - Dipartimento di Scienze della Salute, Università degli Studi di Milano, Milano, Italy.
Manzoni M; Unità di Medicina II, ASST Santi Paolo e Carlo - Dipartimento di Scienze della Salute, Università degli Studi di Milano, Milano, Italy.
Podda GM; Unità di Medicina II, ASST Santi Paolo e Carlo - Dipartimento di Scienze della Salute, Università degli Studi di Milano, Milano, Italy.
Casazza G; Dipartimento di Scienze Biomediche e Cliniche L. Sacco, Università degli Studi di Milano, Milano, Italy.
Cattaneo M; Unità di Medicina II, ASST Santi Paolo e Carlo - Dipartimento di Scienze della Salute, Università degli Studi di Milano, Milano, Italy.
Źródło:
European journal of clinical investigation [Eur J Clin Invest] 2021 Jan; Vol. 51 (1), pp. e13433. Date of Electronic Publication: 2020 Oct 31.
Typ publikacji:
Journal Article; Meta-Analysis
Język:
English
Imprint Name(s):
Publication: Oxford : Wiley
Original Publication: Berlin, New York, Springer-Verlag, on behalf of the European Society for Clinical Investigation.
MeSH Terms:
Pulmonary Artery*
COVID-19/*epidemiology
Pulmonary Embolism/*epidemiology
Thrombosis/*epidemiology
Venous Thrombosis/*epidemiology
Anticoagulants/therapeutic use ; Case-Control Studies ; Heparin/therapeutic use ; Heparin, Low-Molecular-Weight/therapeutic use ; Humans ; Prevalence ; Pulmonary Embolism/prevention & control ; SARS-CoV-2 ; Thrombosis/prevention & control ; Venous Thrombosis/prevention & control
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Contributed Indexing:
Keywords: COVID-19; SARS coronavirus; embolism and thrombosis; low-molecular-weight heparin
Substance Nomenclature:
0 (Anticoagulants)
0 (Heparin, Low-Molecular-Weight)
9005-49-6 (Heparin)
Entry Date(s):
Date Created: 20201014 Date Completed: 20210101 Latest Revision: 20210110
Update Code:
20240105
PubMed Central ID:
PMC7646003
DOI:
10.1111/eci.13433
PMID:
33053206
Czasopismo naukowe
Background: COVID-19 patients are considered at high risk of venous thromboembolism (VTE). The real nature of pulmonary artery occlusions (PAO) in COVID-19 has been questioned, suggesting that it is caused also by in situ thrombi, rather than only by emboli (PE) from peripheral thrombi.
Methods: We searched MEDLINE for studies published until 6 June 2020 that included COVID-19 patients or non-COVID-19 medical patients at VTE risk, treated with heparins, in whom VTE (PE and deep vein thrombosis, DVT) had been reported. Systematic review and results reporting were conducted in accordance with PRISMA guidelines. Data were independently extracted by two observers, and estimates were pooled using random-effects meta-analysis.
Results: We identified 17 studies including 3224 COVID-19 patients and 7 including 11 985 non-COVID-19 patients. Two analyses were performed: in all COVID-19 patients and only in those (n = 515) who, like non-COVID-19 patients, were screened systematically for DVT. The latter analysis revealed that the prevalence of DVT was 15.43% (95%CI, 4.08-31.77) in COVID-19 and 4.21% (2.27-6.68) in non-COVID-19 patients (P = .0482). The prevalence of PE was 4.85% (40.33-13.01) in COVID-19 patients and 0.22% (0.03-0.55) in non-COVID-19 patients (P = .0128). The percentage of PE among VTE events was 22.15% (5.31-44.60) in COVID-19 and 6.39% (3.17-10.41) in non-COVID-19 patients (P = .0482). Differences were even more marked when all COVID-19 patients were analysed.
Conclusions: The results of our meta-analysis highlight a disproportion in the prevalence of PE among all VTE events in COVID 19 patients, likely reflecting PAO by pulmonary thrombi, rather than emboli from peripheral vein thrombi.
(© 2020 Stichting European Society for Clinical Investigation Journal Foundation. Published by John Wiley & Sons Ltd.)
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